Online Booking

All new clients are required to submit the client form as per below. If you have any trouble using this form, please email us directly at info@livelylifestylespsychology.com.

EXISTING CLIENTS
If you’re an existing client, use this the link to book your appointment using the client portal.

New Client Form

I understand that Lively Lifestyles Psychology does not provide crisis services or immediate appointments, court reports, one-off assessments or services via third parties.

I understand that limited appointments are available on Thursdays, Fridays and Saturdays, and appointments currently are only accessible via secure Telehealth video platform

First Name

Last Name

Phone

Address

How did you hear about Lively Lifestyles Psychology?

Date of birth

Please provide detail about the reason for your referral, and the main things you wish to discuss with a psychologist.

Please tick the issue/s you would like help with (please select at least one issue) * Required

Conception Difficulties

Fertility-related Depression & Anxiety

IVF & Assisted Reproductive Treatment

Miscarriage & Stillbirth

Neonatal & Infant Loss

Pregnancy after loss

Difficult Foetal Diagnoses

Termination for Medical Reasons

Birth Trauma

Worrying & Obsessive Thoughts

Pre & Postnatal Depression & Anxiety

Adjustment & Managing Feelings of Overwhelm

Relationship Difficulties

Parenting of Infants & Toddlers

If there is something else you are seeking support with, but it is not on the list above, please indicate what it is:

Are you currently seeing a psychiatrist? *

Yes

Have you previously been hospitalised for reasons related to your mental health? If yes, please provide detail. *

Yes

Are you currently taking any medication for your mental health? If yes, please provide detail. *

Yes

Do you have a Medicare referral/GP letter/Mental Health Treatment Plan? *

Yes

I would like to have a free intake call of 10-15minutes with Lively Lifestyles Psychology prior to booking in my appointment.

Thanks for submitting!

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